Active NPI
22 Tuck Road Operations LLC
Doing business as Oceanside Skilled Nursing & Rehabilitation
- Skilled Nursing Facility
- Hampton, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 03405
- Legal business name
- 22 TUCK ROAD OPERATIONS LLC
- Doing business as
- Oceanside Skilled Nursing & Rehabilitation
- Practice address
- 22 Tuck Rd
Hampton, NH 03842-1225 - Phone
- (603) 926-4551
- Fax
- (603) 929-3031
- NPI assigned
- Sep 30, 2008
- Last updated
- Jan 19, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael T Berg
- Title
- Assistant Secretary
- Phone
- (505) 468-4742
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 03405 | NH | Primary |
Addresses
Primary practice location
22 Tuck Rd
Hampton, NH 03842-1225
Mailing address
22 Tuck Rd
Hampton, NH 03842-1225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30106737 | Medicaid | NH |
Other names 1
- Oceanside Skilled Nursing & Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081125000480 | NH | Part A Provider - Skilled Nursing Facility | 0840350583 | Practice locations: Hampton, NH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1053561704. Details of each certification follow.
Skilled nursing facility certification: CCN 305055A
- Legal name
- 22 TUCK ROAD OPERATIONS LLC
- Doing business as
- OCEANSIDE SKILLED NURSING AND REHABILITATION
- Organization structure
- LLC
- Incorporated
- Aug 15, 2008 in PA
- Enrollment address
- 22 Tuck Rd
Hampton, NH 03842-1225 - Nursing home name
- OCEANSIDE SKILLED NURSING AND REHABILITATION
- Affiliated entity
- GENESIS HEALTHCARE
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 30D0087367 | Oceanside Skilled Nursing and Rehabilitation | Certificate of waiver | Aug 22, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 22
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Genesis Omg Operations LLC | 5% Or Greater Direct Ownership Interest | Mar 2, 2015 | 100% |
| Laura Bridgeford | Corporate Officer | Jun 1, 2024 | |
| Adp of the SNF | Jan 31, 2025 | ||
| HCCF Management Group XI LLC | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 14.69% |
| Adp of the SNF | Jan 26, 2025 | ||
| Gen Operations I LLC | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Smit Patel | Operational/Managerial Control | Mar 1, 2024 | |
| Adp of the SNF | Jan 26, 2025 | ||
| Gen Operations II LLC | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| FC-Gen Operations Investment LLC | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Amanda Hernandez | Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Jan 26, 2025 | ||
| Sundance Rehabilitation Holdco Inc | 5% Or Greater Indirect Ownership Interest | Mar 2, 2015 | 5.2% |
| Genesis Healthcare LLC | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Sun Healthcare Group Inc | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 25.75% |
| Arnold M Whitman | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 17.37% |
| Genesis Healthcare Inc | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Zac Properties XI LLC | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 8.46% |
| Steven E Fishman | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 11.02% |
| Avi Pinchas Mendelson | Corporate Officer | Jun 1, 2024 | |
| Michael T Berg | Corporate Officer | Mar 2, 2015 | |
| Welltower Inc | 5% Or Greater Indirect Ownership Interest | Apr 1, 2019 | 5.7% |
| GHC Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2012 | 100% |
| Genesis Holdings LLC | 5% Or Greater Indirect Ownership Interest | Mar 2, 2015 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Boston, MA
- NPI 1891062691
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 177
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Laconia Rehab Center
- Skilled Nursing Facility
- Laconia, NH
- NPI 1720260557
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
dba Hackett Hill Center
- Skilled Nursing Facility
- Manchester, NH
- NPI 1750784807
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
dba Harris Hill Center
- Skilled Nursing Facility
- Concord, NH
- NPI 1467634287
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
dba Lebanon Center
- Skilled Nursing Facility
- Lebanon, NH
- NPI 1538341367
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
dba Ridgewood Center
- Skilled Nursing Facility
- Bedford, NH
- NPI 1528240355
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
dba Elm Wood Center at Claremont
- Skilled Nursing Facility
- Claremont, NH
- NPI 1396995056
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, Genesis Omg Operations LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group
-
dba Crest
- Skilled Nursing Facility
- Milford, NH
- NPI 1073176814
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation Holdco Inc, Zac P
-
dba Rochester Manor
- Skilled Nursing Facility
- Rochester, NH
- NPI 1508232414
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation Holdco Inc, Zac Properties XI LLC
-
dba Pheasant Wood Center
- Skilled Nursing Facility
- Peterborough, NH
- NPI 1518520352
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation Holdco Inc, Zac P
-
dba Keene Center
- Skilled Nursing Facility
- Keene, NH
- NPI 1457533275
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
dba Mountain Ridge Center
- Skilled Nursing Facility
- Franklin, NH
- NPI 1700068533
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
dba Applewood Center
- Skilled Nursing Facility
- Winchester, NH
- NPI 1538722368
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation Holdco Inc, Zac P
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Pelham, NH
- NPI 1275700825
-
- Geriatric Medicine (Internal Medicine) Physician
- Boston, MA
- NPI 1891062691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705622400000",
"number": "1053561704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 TUCK RD",
"city": "HAMPTON",
"state": "NH",
"postal_code": "038421225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 TUCK RD",
"city": "HAMPTON",
"state": "NH",
"postal_code": "038421225",
"telephone_number": "603-926-4551",
"fax_number": "603-929-3031"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "22 TUCK ROAD OPERATIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-30",
"last_updated": "2024-01-19",
"certification_date": "2024-01-19",
"status": "A",
"authorized_official_last_name": "BERG",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "ASSISTANT SECRETARY",
"authorized_official_telephone_number": "505-468-4742"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NH",
"license": "03405",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30106737",
"state": "NH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Oceanside Skilled Nursing & Rehabilitation",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Oceanside Skilled Nursing & Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hampton, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.